Academic Consortium on Criminal Justice Health: Health Risks of Jail/NYC Jail System

Date of Review: April, 2019

This resource, ‘Health Risks of Jail/NYC Jail System’, is a recorded online video of a lecture about the historical forces leading to the endemic of mass incarceration that is unique to the US large due to the sociological criminalization of serious mental illness (bi-polar, schizophrenia) and Dr. MacDonald presents compelling data about under- treatment of TBI and substance abuse disorders. The human rights issues experienced by staff around dual loyalty (patients and security apparatus) require ethical decision making frameworks (discussed in another lecture in this series). Some of the other issues around patient safety and human rights include many health risks of jail like injury rates with data showing much higher rates of injury including slip and fall injury; suicide (leading cause of death) ; self-harm; TBIs and consequent mental health and behavioral health disorders; severe withdrawal; post-release mortality usually due to overdose and of course infectious disease risks; close and overcrowded conditions. Finally, the population of homeless individuals were found to be frequently incarcerated for minor infractions and when they were examined more it became clear that they were part of the institutional circuit which includes jails; shelters; emergency departments; psych wards; etc; that all serve the role of housing. Often these issues are further compounded by previous traumatic or structural violence upstream from these incarcerations. Improvements in policy and procedure have come about including integrated approaches to mental health disorders and supportive housing interventions. Protecting younger adults and those with serious mental health illness are other improvements described in this talk. The impacts and risks of mass incarceration. Dr. MacDonald identifies the impact and health risks of mass incarceration or jails to argue that as a society, we need to use incarceration only when necessary and to deliver appropriate, safe, quality care for health needs both upstream and mitigate potential harm that comes from these risks for justice involved patients. This is a video recording of a lecture given at NYU Medical Center; with the speaker facing the camera/audience and PowerPoint slides on a screen. Despite this static format; the content is compelling and could be used for a preclinical foundational curriculum introducing vulnerable populations or health disparities and equity. Unfortunately, you cannot access the PowerPoint slides but you may be able to email the author. This module is part of an online student curriculum aimed at teaching medical students about criminal justice and guidelines on caring for justice-involved patients. Specific screening, management, treatment and advocacy approaches are described in the seven 30-40 minute correctional health curriculum’s video lectures, which is part of an offering from the ACCJH. The ACCJH built this curriculum with partners from the University of Massachusetts, Harvard and Cornell with the goal of education and inspiring students to become advocates. — Ashti Doobay-Persaud, MD, NCEAS

Corresponding Author’s Email:

ross.macdonald@nyulangone.org

Institution:

NYC Health and Hospitals/Correctional Health Services

Source of the Curriculum/Resource:

Online